Malaria remains a major scourge in Malawi, one of the poorest countries of the world, but a country favored by a Ministry of Health responsive to data, and by being selected as one of fifteen countries to receive support from the United States' President's Malaria Initiative (PMI). PMI funds will be used to scale up well-established malaria interventions, and this training grant will help to create and sustain the capacity in Malawi to manage the programs, monitor and evaluate their effectiveness, use the data generated to inform decision making. A portion of the training grant funds will be devoted to improving the grants management capacity at the collaborating institution, the University of Malawi College of Medicine, so that future awards can be made directly to investigators in Malawi. We will use a 'sandwich' approach to the training: the middle layer consists of Malawians who have been educated in relevant scientific disciplines, but lack training in the more programmatic areas described above. These 'evolving experts' will be mentored by established experts in program management, monitoring and evaluation, epidemiology and grants management. The established experts know Malawi well, and have a track record of working successfully with the 'evolving experts' and others in Malawi. After three years of preparation, which will include short courses, on-line training, mentored readings, curriculum development and piloted versions of new training programs, the Malawian 'evolving experts' will themselves train Malawian health workers from District Health Management Teams. Training of the administrative staff in the College of Medicine will occur throughout the five years of the program. Didactic training will be minimized in favor of on-the-job mentoring; this has been found to be highly effective in Malawi and will minimize time away from work for the trainees. Program evaluation will be carried out by the outside experts during their annual visits to Malawi, and successful elements will be identified for subsequent scale-up on a national level. PUBLIC HEALTH RELEVANCE: Malawi is a malaria-endemic country in which academic investigators work effectively with health policy makers. The aim of this training grant is to create the capacity in Malawi to scale up proven antimalarial interventions nationwide, and to identify barriers to achieving targets. This proposal builds on decades of collaboration between investigators at Michigan State University and the University of Malawi College of Medicine in support of the national malaria prevention and control program.